Min Jung Kim, David Prieto-Merino, Jennifer Nicholas, Luke Allen, Matthew J. Burton, Andrew Bastawrous, David Macleod
{"title":"Evidence-Based Approaches to Quality Improvement: A Narrative Review of Integrating Bayesian Adaptive Trials Into Health Services","authors":"Min Jung Kim, David Prieto-Merino, Jennifer Nicholas, Luke Allen, Matthew J. Burton, Andrew Bastawrous, David Macleod","doi":"10.1111/jep.70197","DOIUrl":"https://doi.org/10.1111/jep.70197","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Quality improvement (QI) in health service programmes aims to make small, incremental changes to increase reach and efficiency. Simple, low-risk programmatic changes can improve services, particularly when supported by robust evidence. However, in health service contexts, there is tension between the need for swift decision-making and the high research standards for conducting methodologically rigorous trials. Randomized trials are rarely used to evaluate these changes due to high costs and long timelines, especially when the changes are expected to result in marginal improvements. Instead, health service programmes frequently introduce changes informed by anecdotal evidence or less robust evaluation methods such as before-and-after comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>In this paper, we present a narrative review of the concepts underlying Bayesian adaptive trial designs for conducting QI research, highlighting their use in the commercial sector and exploring opportunities for cross-industry learning and future application in healthcare settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Relevant studies were selected based on their contextual relevance to the topic, in keeping with the narrative review approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Given that programmatic changes typically yield modest improvements, we recommend that adaptive trial designs can strike a balance between obtaining reliable results and avoiding overly large sample sizes. We review how interim analysis and early stopping can be integrated into trials, allowing the level of rigour to be adjusted according to the proramme specifications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adaptive trial designs hold significant promise for enhancing the QI efforts. To ensure that adaptive trial designs can be successfully integrated into health service contexts, tradeoffs should be made between methodological rigour and resource constraints.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mental Health Support for Aphasia: Insights From Psychiatrists and Psychologists","authors":"Özlem Oğuz, Merve Sapmaz Atalar","doi":"10.1111/jep.70138","DOIUrl":"https://doi.org/10.1111/jep.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Understanding the availability of psychological health services is pivotal in reducing the impact of mental health issues in people with aphasia (PwA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to investigate the insights of psychiatrists and psychologists providing mental health and neuropsychological assessment services to PwA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The research design chosen for the qualitative study is phenomenology. The research sample is purposive and convenience sampling. Through semi-structured interviews conducted on Zoom, lasting between 16 and 50 min, insights were gathered from eight Turkish psychologists and psychiatrists experienced with PwA. Thematic analysis was employed for data analysis, and the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were followed to ensure transparency and rigour in reporting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thematic analysis of interview transcriptions revealed six themes: <i>‘Knowledge and awareness of aphasia’; ‘Accessibility, awareness and prioritisation of services’; ‘Problems experienced with PwA during interactions’; ‘Strategies’; ‘Caregivers’</i> and <i>‘Training’</i>. There are four subthemes: <i>‘Knowledge’, ‘Specialised training’, ‘Challenges in service accessibility’</i> and <i>‘Family and professional awareness’</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study emphasises the necessity of comprehensive training in aphasia and highlights the importance of addressing the psychological well-being of PwA. Failure to consider mental health issues in interventions may hinder recovery. Further research is recommended to raise awareness and highlights the crucial need for mental health services in the context of aphasia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Analysing Adverse Event Databases: Principles, Challenges, and Examples","authors":"Eyal Shahar","doi":"10.1111/jep.70188","DOIUrl":"https://doi.org/10.1111/jep.70188","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Databases of reported adverse events after vaccination are used to detect alarming signals by qualitative methods (case series) and quantitative methods (the proportional reporting ratio).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This methodological-empirical paper explores several key questions: How useful are these databases for detecting alarming signals? To which study design do they correspond? Which measure of association should be computed? Which key biases might operate, and what can be done to avoid or reduce them?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A contemporary methodological tool—causal diagrams—was used to answer these questions. The analytical approach was demonstrated for three possible outcomes of Covid vaccines: Thrombosis with Thrombocytopenia Syndrome, Guillain-Barré Syndrome, and reported death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A database of reported adverse events corresponds to a case-control study and should be analysed accordingly. The preferred measure of association is the odds ratio, not the proportional reporting ratio. Reporting bias operates to overestimate the true odds ratio, whereas control selection bias operates in the opposite direction (underestimation). As illustrated by three examples of reported death, the magnitude of the biases depends on the choice of the reference vaccine. However, extended methodological and empirical work is needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Databases of reported adverse events after vaccination are a rich source for quantitative research, provided that several methodological guidelines are followed. These databases should be analysed according to the principles of a case-control study, and the inference should be drawn on a case-by-case basis. It is crucial to estimate the reporting accuracy of a particular event by the type of vaccine, and only a clinical evaluation of a sample of records can provide this information.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Relationship Between the Health Literacy Levels of Women of Reproductive Age and Their Level of Knowledge About Cancer Screenings","authors":"Bilgesu Çelik, Bihter Akın","doi":"10.1111/jep.70162","DOIUrl":"https://doi.org/10.1111/jep.70162","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The study was planned to determine the relationship between health literacy and knowledge of cancer screening in women of reproductive age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cervical cancer, breast cancer and colorectal cancer screenings are conducted as part of the Turkish National Cancer Screening Program. Therefore, participants' knowledge about cervical cancer, breast cancer and colorectal cancer screening knowledge was measured. Descriptive and relational study were used. Data were collected between 7 November 2023 and 30 April 2024 from all women aged 18–49 living in the Central Anatolia region of Turkey. The instruments used for data collection were the descriptive information form, Turkey Health Literacy Scale (TSOY-32) and Cancer Screening Knowledge Scale. Descriptive, comparative and multiple regression analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The mean age of the women was 30.31 ± 9.49 (min = 18, max = 49). The mean TSOY-32 score of the women was 34.45 ± 7.97. The level of health literacy of the women participating in the study was adequate. The mean score of the Women's Knowledge Scale for Cancer Screenings was 13.76 ± 4.67. The study found a small, positive and significant association between women's health literacy and their knowledge of cancer screenings (<i>p</i> < 0.01). As women's health literacy increases, their knowledge about cancer screening also increases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>It is recommended to assess women's health literacy in midwifery education. The level of women's health literacy should be assessed before cancer screening training is provided in primary health care facilities. It is recommended that cancer screening training be delivered according to the level of health literacy. It is expected that the quality and effectiveness of training will increase in this way. The number of cancer screening trainings in health care facilities should be increased.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Li Zhou, Fangyun Zhao, Yanhua Li, Awang Jinmei, Feilong Tan, Xi Gu, Fan Yang, Wenjie Yin
{"title":"Scientific Management for Healthcare Quality Improvement: The Practice of Six Sigma DMAIC in Prescription Pre-Review Work","authors":"Li Zhou, Fangyun Zhao, Yanhua Li, Awang Jinmei, Feilong Tan, Xi Gu, Fan Yang, Wenjie Yin","doi":"10.1111/jep.70187","DOIUrl":"https://doi.org/10.1111/jep.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prescription pre-review (PPR) is an important part of hospital pharmacy management, which aims to ensure the rationality, safety and effectiveness of prescriptions. However, due to the extensive and specialised nature of prescription review work, coupled with the high work intensity in hospitals, prescription errors occur from time to time, affecting the quality of medical care and patient safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Six Sigma DMAIC management method, as a systematic approach to improve service quality by reducing process variation and defects, was applied for the first time in the rectification practice of PPR work in our hospital. In this study, we investigated the practice of Six Sigma DMAIC methodology and its effectiveness in our hospital's PPR work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study analyzes and compares the improvement of PPR from January to September 2023 after the implementation of Six Sigma DMAIC method with the same period in 2022 before the implementation by defining the problem, measuring the current situation, analysing the causes, improving the process and controlling the effect. The improvement effectiveness was also reflected by the prescription compliance rate of key drugs such as key monitoring drugs, intravenous drugs, and antimicrobial drugs, as well as the clinical satisfaction survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall quality of PPR has been significantly improved compared with the previous period, and the error rate of important prescriptions, including the prescriptions of key monitoring drugs, intravenous drugs, and so on, has been significantly reduced, and the job satisfaction has been increased, so that patient safety and quality of medical care have been effectively guaranteed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The introduction of Six Sigma DMAIC management methodology provides a scientific improvement path for PPR work, and provides an effective reference and important guidance for further improvement of the quality of pharmacy services and pharmacy management work in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Integrating Ideological and Political Education Elements Into the Advanced Nursing Practice Course","authors":"Xiuying Ren, Jianlong Han, Liqing Zhu, Haiyan Jing, Qing Li, Shuling He","doi":"10.1111/jep.70142","DOIUrl":"https://doi.org/10.1111/jep.70142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the effectiveness of integrating ideological and political education elements into advanced nursing practice courses for nursing master's students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a nonequivalent posttest design study. The study selected 24 nursing Master's students who took the advanced nursing practice course between 2023 and 2024 as the experimental group, and nursing Master's students who completed the advanced nursing practice course between 2021 and 2022 as the control group. The experimental group (25 students) received classroom instruction integrated with ideological and political elements, while the control group received traditional classroom teaching. The study compares the academic performance, learning stress and fatigue, critical thinking ability and satisfaction of the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The experimental group's academic performance (84.71 ± 2.76) was significantly higher than that of the control group (75.44 ± 3.84), (<i>p</i> < 0.001). Compared to the control group, students in the experimental group received higher learning feedback and exhibited lower levels of excessive engagement, although there was no significant difference in overall effort between the two groups (<i>p</i> = 0.61). The experimental group's critical thinking ability (151.83 ± 4.48) was significantly higher than that of the control group (128.88 ± 5.24), (<i>p</i> < 0.01). Students in the experimental group also reported higher satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Integrating ideological and political education elements into the advanced nursing practice course can enhance students' academic performance, learning efficiency, critical thinking ability, and course satisfaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xian Lin, Ying Zhang, Ruiying Zhang, Shuai Yang, Lei Wang, Yanfeng Shen, Yuhang Sun, Cheng Chen, Jie Li, Xianjie Hao
{"title":"Post-Surgery Loneliness and Its Influencing Factors in Elderly Patients With Breast Cancer: A Cross-Sectional Study","authors":"Xian Lin, Ying Zhang, Ruiying Zhang, Shuai Yang, Lei Wang, Yanfeng Shen, Yuhang Sun, Cheng Chen, Jie Li, Xianjie Hao","doi":"10.1111/jep.70177","DOIUrl":"https://doi.org/10.1111/jep.70177","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the status of postoperative loneliness and factors influencing it in elderly patients with breast cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The questionnaire survey was conducted between 1 January 2022 and 31 October 2024 in our hospital to screen 229 elderly patients with breast cancer after surgery who met the inclusion criteria. The patients' general information was collected, and their General Alienation Scale, Fear of Disease Progression Scale (short form; FoP-Q-SF), 10-item Connor–Davidson Resilience Scale (CD-RISC10), Social Support Scale (PSSS), Social Constraints Scale (SCS) and General Self-Efficacy Scale (GSES) scores were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Univariate analysis showed that the differences in social detachment scores among patients of different age groups, marital status, education level, per capita monthly income and surgical modality and whether or not they were receiving chemotherapy were significant (<i>p</i> < 0.001). Multifactorial analysis showed that age group, marital status, surgical modality and chemotherapy as well as their FoP-Q-SF, CD-RISC10, PSSS and SCS scores were all associated with loneliness in elderly patients with breast cancer. Structural equation modelling showed that social support (<i>p</i> < 0.001) and mental toughness (<i>p</i> < 0.001) negatively predicted social alienation, and social constraints (<i>p</i> < 0.001) and fear of disease progression (<i>p</i> < 0.001) positively predicted social alienation. Moreover, mental toughness (<i>p</i> < 0.001) and social support (<i>p</i> < 0.001) negatively predicted fear of disease progression. Social constraints negatively influenced mental toughness (<i>p</i> < 0.001), and social support positively influenced mental toughness (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Loneliness in elderly patients with breast cancer is at a moderate level and needs to be improved by further research. Mental toughness, fear of disease progression, a history of chemotherapy and social constraints are influential factors in loneliness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Effects of Diagnosis-Related Group Payments on Hospitalisation Costs, Length of Stay, and In-Hospital Mortality: A Case Study in China","authors":"Ning Wang, Baozhen Dai, Xin Liao, Yan Sun","doi":"10.1111/jep.70153","DOIUrl":"https://doi.org/10.1111/jep.70153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In this study, it was to evaluate the impact of diagnosis-related group (DRG) payments on hospitalisation costs, length of stay (LOS), and in-hospital mortality in Nanjing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A quasi-natural experiment was utilised. The intervention group consisted of patients enroled in the Urban Employee Basic Medical Insurance and Urban and Rural Resident Basic Medical Insurance programmes in Nanjing, while the other patients composed the comparison group. Interrupted time-series analysis and difference-in-differences combined with propensity score matching were employed in this study. The analysis was based on a case-level data set from a tertiary hospital between January 2021 and December 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The introduction of the DRG payment caused a 13.5% decrease in hospitalisation costs per admission for the intervention group compared with the comparison group. Furthermore, the intervention group exhibited a slight reduction in the LOS of 0.75 days in comparison to the comparison group. No significant changes were observed in care quality, as measured by in-hospital mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The DRG payment was effective in decreasing hospitalisation costs and length of stay. No compelling evidence was identified in terms of the changes in in-hospital mortality. The evidence from China may also be valuable to other developing countries considering the adoption of DRG payments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Scale Development Study: Ethical Sensitivity Towards Artificial Intelligence and Robot Nurses","authors":"Eda Ergin, Gamze Goke Arslan, Sebnem Cinar Yücel","doi":"10.1111/jep.70151","DOIUrl":"https://doi.org/10.1111/jep.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Socially assistive robots use social interactions to monitor, coach, provide companionship, and support health-promoting activities. However, the widespread use of artificial intelligence and robot nurse applications in many areas leads to ethical dilemmas and concerns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A methodological study was conducted in two phases: (1) development of the scale through a literature review and interviews related to Ethical Sensitivity towards Artificial Intelligence and Robot Nurses; (2) confirming construct validity, criterion-related validity and reliability of the developed scale. The data were collected from 356 nursing students studying at the Nursing Department of a university in Turkey between November 2022 and December 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The scale consists of 17 items and four sub-dimensions, which accounts for 55.84% of the total variance. The Cronbach's alpha value of the scale was 0.83, which was considered as significant. The Kaiser-Meyer-Olkin value of the Ethical Sensitivity Scale for Artificial Intelligence and Robot Nurses was 0.76, and its Bartlett's Test of Sphericity results were as follows: χ<sup>2</sup> = 1174.25, <i>p</i> = 0.000. According to the results of the Confirmatory Factor Analysis, fit indices were determined as follows: χ<sup>2</sup>/SD = 1.979, Root Mean Square Error of Approximation = 0.074, Comparative Fit Index = 0.894, Incremental Fit Index = 0.897 and Goodness of Fit Index = 0.880.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Ethical Sensitivity Scale for Artificial Intelligence and Robot Nurses was determined as a valid and reliable measurement tool. It is recommended that the Ethical Sensitivity Scale for Artificial Intelligence and Robot Nurses should be used in different sample groups, different cultures and societies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Introduction of a Third Trimester Pregnancy Patient Education Guide and Effects on Patient Satisfaction With Counseling: A Prospective Cohort Study","authors":"Clarice Hu, Julie Hurvitz, Jessica K. Lee","doi":"10.1111/jep.70202","DOIUrl":"https://doi.org/10.1111/jep.70202","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>To assess whether a workflow change introducing a third trimester pregnancy education guide would be associated with increased patient satisfaction regarding prenatal counseling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We surveyed pregnant patients between 34w0d-41w6d during a single prenatal appointment at one of two hospital-associated offices. We enrolled 49 ‘pre-guide’ patients March-May 2023 and 50 ‘post-guide’ patients October–December 2023, after a 4-month washout period. We performed <i>t</i>-tests and chi-squared analyses to compare the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohorts had similar sociodemographic characteristics aside from lower education level in the post-guide cohort (<i>p</i> = 0.01). There was no significant difference between the groups and their reported satisfaction with third trimester and delivery counseling (<i>p</i> = 0.92). Those who received the guide were more likely to feel they were more adequately counseled regarding ‘pain management in childbirth’ (<i>p</i> = 0.01), but there were no other statistically significant differences between the groups. Of those who received the guide, 75% felt that it reduced their anxiety and stress about the unknown and 100% would recommend it to others.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We did not find that introduction of an informational guide about the third trimester of pregnancy significantly affected their satisfaction with their third trimester and delivery counseling or patient perception of the adequacy of counseling on specific pregnancy topics. All patients who received the guide noted they would recommend it to others.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144573333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}